Healthcare Provider Details
I. General information
NPI: 1346958204
Provider Name (Legal Business Name): ALTERA HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2022
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3311 S RAINBOW BLVD STE 108
LAS VEGAS NV
89146-6596
US
IV. Provider business mailing address
13113 GIRO DR
BAKERSFIELD CA
93314-6600
US
V. Phone/Fax
- Phone: 702-703-5597
- Fax:
- Phone: 702-703-5597
- Fax: 702-508-2435
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WD0400X |
| Taxonomy | Diabetes Educator Registered Nurse |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RUBY
TAN
RAMOS
Title or Position: APRN OWNER
Credential:
Phone: 661-345-9964